Provider Demographics
NPI:1760878896
Name:NAZAK MOZAFFARIEH
Entity Type:Organization
Organization Name:NAZAK MOZAFFARIEH
Other - Org Name:EYES & SMILES OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZAK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOZAFFARIEH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-222-3020
Mailing Address - Street 1:1773 SAN PABLO AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2084
Mailing Address - Country:US
Mailing Address - Phone:510-222-3020
Mailing Address - Fax:510-222-9020
Practice Address - Street 1:1773 SAN PABLO AVE STE A1
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2084
Practice Address - Country:US
Practice Address - Phone:510-222-3020
Practice Address - Fax:510-222-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12430152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty